Combination first-line treatment with the PD-L1 inhibitor atezolizumab plus bevacizumab resulted in prolonged progression-free survival compared with standard sunitinib in patients with PD-L1–positive metastatic renal cell carcinoma, according to the results of the IMmotion151 trial.1
With a median follow-up of 15 months, patients with PD-L1–positive disease assigned to treatment with atezolizumab plus bevacizumab had a median progression-free survival of 11.2 months compared with 7.7 months for sunitinib (hazard ratio (HR), 0.74; 95% CI, 0.57-0.96; P =.0217).
“The observed progression-free survival benefit of atezolizumab plus bevacizumab extended across different examined clinical groups, including previous nephrectomy, sarcomatoid groups, including previous nephrectomy, sarcomatoid histology, and established prognostic risk groups,” the researchers wrote.
However, an overall survival analysis in the intention-to-treat population found no difference in median overall survival, and “longer-term follow-up is necessary to established whether a survival benefit will emerge.”
The phase 3 study included 915 patients with clear cell or sarcomatoid histology who were randomly assigned to atezolizumab plus bevacizumab (454 individuals) or sunitinib (461 individuals). Forty percent of patients had PD-L1–positive disease.
Among patients with PD-L1–expressing disease, 43% had a confirmed objective response with combination treatment, including 9% with complete response. Among patients assigned to receive sunitinib, 35% achieved an objective response, with 4% of patients achieving a complete response.
The safety profile was similar to that previously reported.
Disclosure: The original study was funded by F Hoffmann-La Roche Ltd and Genentech Inc. For a full list of disclosures, please see the study.
- Rini BI, Powles T, Atkins MB, et al. Atezolizumab plus bevacizumab versus sunitinib in patients with previously untreated metastatic renal cell carcinoma (IMmotion151): a multicentre, open-label, phase 3, randomized controlled trial [published online May 9, 2019]. Lancet Oncol. doi: 10.1016/S0140-6736(19)30723-8